Objective To analyze the differences in serum amino acid levels between preeclampsia(PE)and normal pregnant women in Urumqi,and to explore the correlation between amino acids with statistically significant differences and PE severity,as well as their diagnostic value for PE patients.Methods A total of 49 normal pregnant women who visited Urumqi Maternal and Child Health Hospital from June 2021 to June 2023 were selected as the control group and 55 PE pregnant women were selected as the PE group,and the PE group was further divided into mild PE group(25 cases)and severe PE group(30 cases).Liquid chromatogra-phy-tandem mass spectrometry technology was used to determine the levels of 25 metabolites in pregnant women's serum.Spearman correlation analysis was used to analyze the correlation between the amino acid lev-els and PE severity.Logistic regression was used to correct for potential confounding factors,and receiver op-erating characteristic curve was used to analyze the diagnostic efficacy of amino acids with significant differ-ences in PE.Results There were statistically significant differences in the body mass index(BMI)and deliv-ery method between the PE group and the control group(P＜0.05).The serum levels of histidine,threonine,glutamine,ethanolamine,methylhistidine,and canine uric acid in the PE group were higher than those in the control group(P＜0.05).The serum levels of threonine,glutamine,methylhistidine,and canine uric acid in the severe PE group were higher than those in the mild PE group and control group(P＜0.05).The serum ethanolamine levels in the mild group and severe PE group were higher than those in the control group(P＜0.05).The serum histidine levels in the severe PE group were higher than those in the control group(P＜0.05).Correlation analysis showed that serum glutamine,ethanolamine,methylhistidine,and canine uric acid were positively correlated with the severity of PE(P＜0.05).After adjusting for BMI,there were still statisti-cally significant differences in the levels of threonine,glutamine,and methylhistidine between the PE group and the control group(P＜0.05).The area under the curve of the combined detection of serum threonine,glu-tamine,and methylhistidine for diagnosing PE was 0.734.Conclusion There is a certain correlation between serum levels of threonine,glutamine,and methylhistidine and the severity of PE,and the combined detection has high diagnostic value for patients with PE.

Objective:To explore the influencing factors of hospitalization cost of acute myeloid leukemia, to group the cases based on decision tree model and to provide reference for improving the DRG management in this regard.Methods:Homepage data were retrieved from the medical records with acute myeloid leukemia as the main diagnosis (the top four ICD codes were C92.0, C92.4, C92.5, and C93.0). These patients were discharged from the clinical hematology department of the Fujian Institute of Hematology from January 2020 to December 2021. Then the influencing factors of hospitalization expenses were identified using Wilcoxon rank sum test or Kruskal-Wallis rank sum test and multiple linear stepwise regression analysis, with such factors used as classification nodes. The decision tree model of χ2 automatic interactive testing method was used to group the cases so included. At the same time, the included cases were grouped according to the trial run C-DRG version in Fujian province, for comparison of the differences between the two grouping methods. Results:The length of stay, the type of treatment, whether associated complications and age of patients were found as the influencing factors for the hospitalization costs of patients with acute myeloid leukemia, and such factors were included in the decision tree model to form 9 case mixes. The variance reduction of this model was 75.77%, featuring a high inter-group heterogeneity, and the coefficient of variation was 0.33-0.61, featuring a low in-group difference. The patients were divided into two groups according to the C-DRG version in Fujian province. The variance reduction of this method was 27.57%, featuring a low inter-group heterogeneity, and the coefficients of variation were 0.59 and 1.25, featuring high in-group difference.Conclusions:The cases of acute myeloid leukemia were grouped based on length of stay, type of treatment, whether accompanied by complications, and age proved reasonable enough to serve as reference for DRG management and cost control of this disease.

We report a critically ill pregnant woman in the third trimester with severe pneumonia due to COVID-19 who presented to Xiaolan People's Hospital of Zhongshan in February 2020. The 32-year-old patient was admitted at 35 +2 gestational weeks with a 4-day history of a sore throat and a fever for three hours. The patient had been to Xiaogan City, Hubei Province, and the symptoms occurred during a period of self-isolation after back home. The condition of the patient deteriorated rapidly, with left-sided chest and back pain, shortness of breath, dizziness, progressing to respiratory failure and septic shock 7 hours after her admission. In view of her critical condition and a history of two previous cesarean sections, an emergency cesarean section was performed. Blood gas analysis of the mother before the operation suggested respiratory failure, respiratory acidosis, and metabolic acidosis. During the operation, a baby boy was born. The Apgar score of the boy, birth weight of 2 700 g, was one at 1, 5 and 10 minutes despite the resuscitation efforts. The neonate died after withdrawing treatment. The patient was treated with tracheal intubation ventilator and other supportive treatments after the operation. The result of the new coronavirus nucleic acid test, taken on admission, but which was reported after delivery, was positive. The patient was transferred to the designated hospital for further treatment and was recovering with the withdrawal of extracorporeal membrane oxygenation and ventilation support at 26 and 36 days after surgery, respectively.

Objective: To investigate the influence of serum creatinine (sCr) at different time-points on prognosis of critically ill patients with acute kidney injury (AKI). Methods: This study was retrospectively analyzed the clinical data of critical patients with AKI who admitted to the mixed ICU of Xiaolan Hospital of Southern Medical University during March 2015 and January 2016. According to the clinical prognosis, the patients were divided into the renal replacement therapy (RRT) group and non-renal replacement therapy (non-RRT) group, 28-day renal loss group and renal recover group, hospital death group and survival group. Serum Cr at different time-points and clinical data were collected. The receiver operating characteristic (ROC) curve and the area under curve (AUC) were used to evaluate the capability of sCr at different time-points in predicting clinical prognosis. Results: During the study, 85 AKI patients were enrolled. The in-hospital mortality was 20%, RRT rate was 15.3%, and renal lose at 28 days after ICU admission was 31.8%. The levels of sCr out of ICU (o-sCr) and the peak of sCr were significantly higher in the RRT group than the non-RRT group (P<0.01). The o-sCr and p-sCr predicted RRT during the hospital stay with a higher AUC value (0.806 vs 0.833) than b-sCr and a-sCr. The levels of b-sCr, a-sCr, o-sCr, and p-sCr were all significantly higher in the28-day renal loss group than the kidney recover group (P<0.01). The levels of o-sCr and p-sCr were significantly higher in the hospital death group than the survival group (P<0.05). The o-sCr predicted renal lose at 28 days and hospital death with the highest AUC value of 0.850 and 0.797, respectively. Conclusions It cannot be ignored to monitor dynamically the level of sCr at different time-points in critical patients with AKI, which can predict the clinical prognosis such as hospital death, RRT and renal lose at 28 days after ICU admission.

Objective To evaluate the effect of precision anesthesia strategy on postoperative cognitive function in elderly patients undergoing hip replacement.Methods Seventy elderly patients of both sexes,aged 65-85 yr,weighing 50-75 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective unilateral hip replacement under general anesthesia,with years of education＞6 yr,were divided into 2 groups (n =35 each) using a random number table:precision anesthesia group (group P) and routine anesthesia group (group R).Anesthetic protocol and perioperative management were optimized using precision anesthesia strategy in group P.Routine anesthetic protocol and perioperative management were performed in group R.Peripheral venous blood samples were collected at 1 day before operation (T0) and 1,6,12 and 24 h after operation (T1-4) for determination of serum S100β protein,neuronspecific enolase (NSE),interleukin-1beta (IL-1β),IL-6,tumor necrosis factor-alpha (TNF-α) and Creactive protein (CRP) concentrations by enzyme-linked immunosorbent assay.The patient's cognitive function was assessed using Mini-Mental State Examination (MMSE) at T0 and 3 and 7 days after operation (T5,6).Results Compared with the baseline at T0,the serum S100β protein and NSE concentrations were significantly increased at T1-3,the serum IL-1β,IL-6 and TNF-α concentrations were increased at T1-4,the CRP concentrations were increased at T2,3,MMSE scores were decreased at T5 in group R,and the serum S100β protein,IL-1β and IL-6 concentrations were significantly increased at T1-3,the serum NSE and CRP concentrations were increased at T2,the serum TNF-α concentrations were increased at T1-4,and MMSE cores were decreased at T5 in group P (P＜0.05).Compared with group R,the serum S100β protein and IL-1β concentrations were significantly decreased at T1,2,the serum NSE and TNF-α concentrations were decreased at T1-3,the serum IL-6 concentrations were decreased at T2,3,and MMSE scores were increased at T5 in group P (P＜ 0.05).Conclusion Precision anesthesia strategy can improve postoperative cognitive function in elderly patients undergoing hip replacement,which is related to inhibiting inflammatory responses.

OBJECTIVETo investigate the neuroprotective effects of the constituents in Herba Erigerontis on neuroblastoma SH-SY5Y cells, and find out its possible material foundation in treating Alzheimer's disease (AD).

METHODDifferent combinations of the three constituents in Herba Erigerontis were prepared according to the orthogonality experiment, and the indexes (MTT reduction assay, lipid peroxidation and expressions of nAChR alpha7 protein)were observed upon the SH-SY5Y cells followed by treatment of these combinations and beta-amyloid peptide (AP). The pharmacology data thus obtained and peak data in UPLC fingerprint were analyzed through ANOVA and correlationship by SPSS to give the information of active possible material foundation.

RESULTConstituents B and C showed clear activity and peaks of 4, 7-12 did positive correlationship according to the correlation of fingerprints and pharmacology.

CONCLUSIONThis study makes a valid approach for deducing the active constituents even the exact compounds against neurotoxicity induced by Abeta by correlation of fingerprints and pharmacology.

Alzheimer Disease ; drug therapy ; Amyloid beta-Peptides ; toxicity ; Analysis of Variance ; Animals ; Cell Line, Tumor ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; therapeutic use ; Erigeron ; chemistry ; Humans ; Nervous System ; drug effects ; Neurotoxins ; toxicity

OBJECTIVETo study the effect of progesterone on interleukin-6 (IL-6) release from human umbilic vein endothelial cells (HUVECs) induced by high mobility group box-1 protein (HMGB1).

METHODThe recombinant expression plasmid pET14b-HMGB1 was constructed and transformed into competent E.coli BL21 cells to obtain HMGB1 protein, which was purified with chromatography on Ni-NTA Sepharose column. Cultured HUVECs were treated with purified HMGB1 protein alone at the concentrations 0, 10, 100, 500, and 1000 ng/ml, progesterone alone at the concentrations of 0, 0.1, 1, 10, 100 mmol/L, or with both HMGB1 protein (500 ng/ml) and progesterone at the terminal concentrations of 0, 0.1, 1, 10, and 100 mmol/L. Twenty-four hours later, the supernatant of the cell culture medium was collected to detect the levels of IL-6 using enzyme-linked immunosorbent assay (ELISA).

RESULTSThe IL-6 levels in HUVEC culture medium was slightly decreased after treatment with low-concentration HMGB1 but increased obviously following treatment with high-concentration HMGB1, and these effects could be dose-dependently inhibited by progesterone. Progesterone alone did not result in any noticeable changes of IL-6 levels in the cell culture medium.

CONCLUSIONSProgesterone can dose-dependently inhibit HMGB1-induced IL-6 release from HUVECs, suggesting the protective role of progesterone in endotoxemia.

Cells, Cultured ; Dose-Response Relationship, Drug ; Endothelial Cells ; cytology ; metabolism ; HMG-Box Domains ; HMGB1 Protein ; pharmacology ; Humans ; Interleukin-6 ; biosynthesis ; Progesterone ; pharmacology ; Umbilical Veins ; cytology ; metabolism

Addiction is gaining recognition as a leading cause of death, morbility and lost productivity. The urgent clinical and social need to do something about addiction promotes the development of addciton research. This paper reviews the main advances in this area in the latest thirty years, ranging from the initial targets of the major drugs of abuse, to the cAMP pathway in opiate tolerence and dependence and molecular and cellular mechanisms of addiction in VTA-NAc pathway.